본문 바로가기
KERD
논문KCI 등재

The Innovative Approach in Functional Bladder Disorders: The Communication Between Bladder and Brain-Gut Axis

양승훈|김아람|정지원
대한배뇨장애요실금학회 (Korean Continence Society)|2023.11|International Neurourology Journal|제27권 제1호|pp. 15-22|DOI 10.5213/inj.2346036.018

2

조회

0

다운로드

0

인용

0

참고문헌

키워드

Urinary bladder diseasesMood disordersBrain-gut axisIntestinal diseases

초록

Functional bladder disorders including overactive bladder and interstitial cystitis may induce problems in many other parts of our body such as brain and gut. In fact, diagnosis is often less accurate owing to their complex symptoms. To have correct diagnosis of these diseases, we need to understand the pathophysiology behind overlapped clinical presentation. First, we focused on reviewing literatures that have reported the link between bladder and brain, as the patients with bladder disorders frequently accompanied mood disorders such as depression and anxiety. Second, we reviewed literatures that have described the relationship between bladder and gut. There exist many evidences of patients who suffered from both bladder and intestinal diseases, such as irritable bowel syndrome and inflammatory bowel disease, at the same time. Furthermore, the interaction between brain and gut, well-known as brain-gut axis, might be a key factor that could change the activity of bladder and vice versa. For example, the affective disorders could alter the activity of efferent nerves or autonomic nervous system that modulate the gut itself and its microbiota, which might cause the destruction of homeostasis in bladder eventually. In this way, the communication between bladder and brain-gut axis might affect permeability, inflammation, as well as infectious etiology and dysbiosis in bladder diseases. In this review, we aimed to find an innovative insight of the pathophysiology in the functional bladder disorders, and we could provide a new understanding of the overlapped clinical presentation by elucidating the pathophysiology of functional bladder disorders.

Abstract

Functional bladder disorders including overactive bladder and interstitial cystitis may induce problems in many other parts of our body such as brain and gut. In fact, diagnosis is often less accurate owing to their complex symptoms. To have correct diagnosis of these diseases, we need to understand the pathophysiology behind overlapped clinical presentation. First, we focused on reviewing literatures that have reported the link between bladder and brain, as the patients with bladder disorders frequently accompanied mood disorders such as depression and anxiety. Second, we reviewed literatures that have described the relationship between bladder and gut. There exist many evidences of patients who suffered from both bladder and intestinal diseases, such as irritable bowel syndrome and inflammatory bowel disease, at the same time. Furthermore, the interaction between brain and gut, well-known as brain-gut axis, might be a key factor that could change the activity of bladder and vice versa. For example, the affective disorders could alter the activity of efferent nerves or autonomic nervous system that modulate the gut itself and its microbiota, which might cause the destruction of homeostasis in bladder eventually. In this way, the communication between bladder and brain-gut axis might affect permeability, inflammation, as well as infectious etiology and dysbiosis in bladder diseases. In this review, we aimed to find an innovative insight of the pathophysiology in the functional bladder disorders, and we could provide a new understanding of the overlapped clinical presentation by elucidating the pathophysiology of functional bladder disorders.

참고문헌 (65)

  1. Brown JS, "Comorbidities associated with overactive bladder", Am J Manag Care, 6(11 Suppl), pp.S574~S579 (2000)
  2. Hanno PM, "Diagnosis and treatment of interstitial cystitis", bladder pain syndrome : AUA guideline amendment, 2015, pp.193, 1545~1553
  3. Warren JW, "Evidence-based criteria for pain of interstitial cystitis", painful bladder syndrome in women, 2008, pp.71, 444~448
  4. Pavcovich LA, "Central regulation of micturition in the rat the corticotropin-releasing hormone from Barrington’s nucleus", Neurosci Lett, 196, pp.185~188 (1995)
  5. McFadden K, "Overexpression of corticotropin-releasing factor in Barrington’s nucleus neurons by adeno-associated viral transduction : effects on bladder function and behavior", Eur J Neurosci, 36, pp.3356~3364 (2012)
  6. Koziol JA, "The natural history of interstitial cystitis : a survey of 374 patients", J Urol, 149, pp.465~469 (1993)
  7. Chess-Williams R, "Chronic psychological stress and lower urinary tract symptoms", Low Urin Tract Symptoms, 13, pp.414~424 (2021)
  8. Lutgendorf SK, "Stress and symptomatology in patients with interstitial cystitis : a laboratory stress model", J Urol, 164, pp.1265~1269 (2000)
  9. Wood SK, "Social stress-induced bladder dysfunction : potential role of corticotropin-releasing factor", Am J Physiol Regul Integr Comp Physiol, 296, pp.R1671~R1678 (2009)
  10. Smith AL, "The effects of acute and chronic psychological stress on bladder function in a rodent model", Urology, 78, pp.967.e1~967.e7 (2011)
  11. Valentino RJ, "The bladder-brain connection : putative role of corticotropin-releasing factor", Nat Rev Urol, 8, pp.19~28 (2011)
  12. Robbins MT, "Footshock-induced urinary bladder hypersensitivity : role of spinal corticotropin-releasing factor receptors", J Pain, 9, pp.991~998 (2008)
  13. LaBerge J, "Expression of corticotropin-releasing factor and CRF receptors in micturition pathways after cyclophosphamide-induced cystitis", Am J Physiol Regul Integr Comp Physiol, 291, pp.R692~R703 (2006)
  14. Klausner AP, "The role of corticotropin releasing factor and its antagonist, astressin, on micturition in the rat", Auton Neurosci, 123, pp.26~35 (2005)
  15. Wood SK, "A corticotropin-releasing factor receptor antagonist improves urodynamic dysfunction produced by social stress or partial bladder outlet obstruction in male rats", Am J Physiol Regul Integr Comp Physiol, 304, pp.R940~R950 (2013)
  16. Kiddoo DA, "Impact of state of arousal and stress neuropeptides on urodynamic function in freely moving rats", Am J Physiol Regul Integr Comp Physiol, 290, pp.R1697~R1706 (2006)
  17. Berger M, "The expanded biology of serotonin", Annu Rev Med, 60, pp.355~366 (2009)
  18. de Groat WC, "Influence of central serotonergic mechanisms on lower urinary tract function", Urology, 59, pp.30~36 (2002)
  19. Blier P, "Serotonin and beyond : therapeutics for major depression", Philos Trans R Soc Lond B Biol Sci, 368, pp.20120536~ (2013)
  20. Hamon M, "Monoamine neurocircuitry in depression and strategies for new treatments", Prog Neuropsychopharmacol Biol Psychiatry, 45, pp.54~63 (2013)
  21. Tank AW, "Peripheral and central effects of circulating catecholamines", Compr Physiol, 5, pp.1~15 (2015)
  22. Nemeroff CB, "The neurobiology of depression", Sci Am, 278, pp.42~49 (1998)
  23. Melotti IGR, "Severe depression and anxiety in women with overactive bladder", Neurourol Urodyn, 37, pp.223~228 (2018)
  24. Lai HH, "The relationship between depression and overactive bladder", urinary incontinence symptoms in the clinical OAB population, 2016, pp.16, 60~
  25. Lee HY, "Urinary incontinence and the association with depression, stress, and self-esteem in older Korean Women", Sci Rep, 11, pp.9054~ (2021)
  26. Ma L, "Fluoxetine, a selective serotonin reuptake inhibitor used clinically, improves bladder function in a mouse model of moderate spinal cord injury", Neural Regen Res, 16, pp.2093~2098 (2021)
  27. Espey MJ, "Effect of 5-HT receptor and adrenoceptor antagonists on micturition in conscious cats", Eur J Pharmacol, 221, pp.167~170 (1992)
  28. Redaelli M, "Serotonin and noradrenaline reuptake inhibitors improve micturition control in mice", PLoS One, 10, pp.e0121883~ (2015)
  29. Wrobel A, "Duloxetine reverses the symptoms of overactive bladder co-existing with depression via the central pathways", Pharmacol Biochem Behav, 189, pp.172842~ (2020)
  30. Levine J, "Cerebrospinal cytokine levels in patients with acute depression", Neuropsychobiology, 40, pp.171~176 (1999)
  31. Dowlati Y, "A meta-analysis of cytokines in major depression", Biol Psychiatry, 67, pp.446~457 (2010)
  32. Thor KB, "Effects of duloxetine, a combined serotonin and norepinephrine reuptake inhibitor, on central neural control of lower urinary tract function in the chloralose-anesthetized female cat", J Pharmacol Exp Ther, 274, pp.1014~1024 (1995)
  33. 왕승민, "Overactive Bladder Successfully Treated with Duloxetine in a Female Adolescent", Clinical Psychopharmacology and Neuroscience, 13(2), pp.212~214 (2015), 대한정신약물학회
  34. Cheng CL, "Role of 5-HT1A receptors in control of lower urinary tract function in anesthetized rats", Am J Physiol Renal Physiol, 298, pp.F771~F778 (2010)
  35. Ramage AG, "The role of central 5-hydroxytryptamine (5-HT, serotonin)receptors in the control of micturition", Br J Pharmacol, 147(Suppl 2), pp.S120~S131 (2006)
  36. Klingele CJ, "Dysfunctional urinary voiding in women with functional defecatory disorders", Neurogastroenterol Motil, 22, pp.e1094~e1284 (2010)
  37. Malykhina AP, "Do the urinary bladder and large bowel interact, in sickness or in health? ICI-RS 2011", Neurourol Urodyn, 31, pp.352~358 (2012)
  38. Monga AK, "Is there an irritable bladder in the irritable bowel syndrome?", Br J Obstet Gynaecol, 104, pp.1409~1412 (1997)
  39. Alagiri M, "Interstitial cystitis : unexplained associations with other chronic disease and pain syndromes", Urology, 49, pp.52~57 (1997)
  40. Franco I, "Overactive bladder in children. Part 1: Pathophysiology", J Urol, 178(3 Pt 1), pp.761~768 (2007)
  41. Lei Q, "Lack of transient receptor potential vanilloid 1 channel modulates the development of neurogenic bladder dysfunction induced by cross-sensitization in afferent pathways", J Neuroinflammation, 10, pp.3~ (2013)
  42. Bielefeldt K, "Convergence of sensory pathways in the development of somatic and visceral hypersensitivity", Am J Physiol Gastrointest Liver Physiol, 291, pp.G658~G665 (2006)
  43. Qin C, "Cross-organ sensitization of lumbosacral spinal neurons receiving urinary bladder input in rats with inflamed colon", Gastroenterology, 129, pp.1967~1978 (2005)
  44. Malykhina AP, "Colonic inflammation increases Na+ currents in bladder sensory neurons", Neuroreport, 15, pp.2601~2605 (2004)
  45. Lei Q, "Colonic inflammation up-regulates voltagegated sodium channels in bladder sensory neurons via activation of peripheral transient potential vanilloid 1 receptors", Neurogastroenterol Motil, 24, pp.575~585e257 (2012)
  46. Ustinova EE, "Colonic irritation in the rat sensitizes urinary bladder afferents to mechanical and chemical stimuli : an afferent origin of pelvic organ cross-sensitization", Am J Physiol Renal Physiol, 290, pp.F1478~F1487 (2006)
  47. Yoshikawa S, "Pelvic organ cross-sensitization to enhance bladder and urethral pain behaviors in rats with experimental colitis", Neuroscience, 284, pp.422~429 (2015)
  48. Pezzone MA, "A model of neural cross-talk and irritation in the pelvis : implications for the overlap of chronic pelvic pain disorders", Gastroenterology, 128, pp.1953~1964 (2005)
  49. Berg G, "Microbiome definition re-visited : old concepts and new challenges", Microbiome, 8, pp.103~ (2020)
  50. Perez-Carrasco V, "Urinary microbiome : Yin and Yang of the urinary tract", Front Cell Infect Microbiol, 11, pp.617002~ (2021)
  51. Hans G. Pohl, "The Urine Microbiome of Healthy Men and Women Differs by Urine Collection Method", International Neurourology Journal, 24(1), pp.41~51 (2020), 대한배뇨장애요실금학회[DOI]
  52. Barnett BJ, "Urinary tract infection : an overview", Am J Med Sci, 314, pp.245~249 (1997)
  53. Levy M, "Dysbiosis and the immune system", Nat Rev Immunol, 17, pp.219~232 (2017)
  54. Mueller ER, "Female urinary microbiota", Curr Opin Urol, 27, pp.282~286 (2017)
  55. Siddiqui H, "Alterations of microbiota in urine from women with interstitial cystitis", BMC Microbiol, 12, pp.205~ (2012)
  56. Wu P, "Urinary microbiome and psychological factors in women with overactive bladder", Front Cell Infect Microbiol, 7, pp.488~ (2017)
  57. Nickel JC, "A culture-independent analysis of the microbiota of female interstitial cystitis", bladder pain syndrome participants in the MAPP research network, 2019, pp.8, 415~
  58. Karstens L, "Does the urinary microbiome play a role in urgency urinary incontinence and its severity?", Front Cell Infect Microbiol, 6, pp.78~ (2016)
  59. Ringel Y, "The intestinal microbiota and irritable bowel syndrome", J Clin Gastroenterol, 49(Suppl 1), pp.S56~S59 (2015)
  60. Lewis DA, "The human urinary microbiome; bacterial DNA in voided urine of asymptomatic adults", Front Cell Infect Microbiol, 3, pp.41~ (2013)
  61. Arumugam M, "Enterotypes of the human gut microbiome", Nature, 473, pp.174~180 (2011)
  62. Kogan MI, "Human urine is not sterile-shift of paradigm", Urol Int, 94, pp.445~452 (2015)
  63. Tap J, "Towards the human intestinal microbiota phylogenetic core", Environ Microbiol, 11, pp.2574~2584 (2009)
  64. Kurokawa K, "Comparative metagenomics revealed commonly enriched gene sets in human gut microbiomes", DNA Res, 14, pp.169~181 (2007)
  65. Pearce MM, "The female urinary microbiome : a comparison of women with and without urgency urinary incontinence", mBio, 5, pp.e01283-14~ (2014)

관련 논문AI추천

Clinical Approach to Recurrent Voiding Dysfunction, Dysuria, and Pelvic Pain Persisting for at Least 3 Months김계환, 김수진대한배뇨장애요실금학회 · International Neurourology Journal2022 · 제26권 제3호Potential Mechanisms Underlying the Increased Excitability of the Bladder Afferent Pathways in Interstitial Cystitis/Bladder Pain Syndrome김두상대한요로생식기감염학회 · Urogenital Tract Infection2018 · 제13권 제2호Is There Any Difference Between Depression and Anxiety in Overactive Bladder According to Sex? A Systematic Review and Meta-AnalysisCássia Raquel Teatin Juliato, Cassio Luiz Zanettini Riccetto, Iane Glauce R Melotti, Marcelo Lima, Suelene Costa de Albuquerque Coelho대한배뇨장애요실금학회 · International Neurourology Journal2017 · 제21권 제3호성별에 따른 과민성방광증후군 심각도와 지각된 스트레스 및 우울과의 관련성 차이박종, 남지영, 류소연, 최성우한국보건정보통계학회 · 보건정보통계학회지2019 · 제44권 제1호간질성 방광염에서 염증반응으로 인한 요로점막의 변화배재현, 최훈상대한요로생식기감염학회 · Urogenital Tract Infection2013 · 제8권 제2호Pathomechanism of Interstitial Cystitis/Bladder Pain Syndrome and Mapping the Heterogeneity of DiseaseHann-Chorng Kuo, Jia-Fong Jhang대한배뇨장애요실금학회 · International Neurourology Journal2016 · 제20권 제1호

이 간행물의 다른 논문 (17건)

Video Urodynamics in the Digital Age: What Have We Overlooked?강은미, 이택, 이혜영pp. 1-2Dynamics in Neurourology은성종pp. 1-2Updates of Overactive Bladder in Pediatrics오미미, 심지성pp. 3-14The Metaverse for Healthcare: Trends, Applications, and Future Directions of Digital Therapeutics for Urology김은정, 김정윤pp. 3-12Intravesical Bladder Treatment and Deep Learning Applications to Improve Irritative Voiding Symptoms Caused by Interstitial Cystitis: A Literature Review윤승현, 조용원pp. 13-20
원문 보기